Does Health Insurance Cover Gynecomastia?
Health insurance companies may cover some portion of your treatment for the condition of gynecomastia, depending on the type of treatment you seek and the specifics of your health insurance plan. The condition, which is a swelling of the male breast tissue, may end up going away on its own.
Insurance companies may not be open to paying for any type of treatment because it does have the chance of subsiding if left untreated, and it is not typically a threat to your overall health. The Mayo Clinic says gynecomastia is usually not a harmful or dangerous condition, although it can be embarrassing or damaging to your self image.
What causes gynecomastia?
Gynecomastia is caused by a hormone imbalance, and namely an imbalance of testosterone and estrogen. Males have a small amount of estrogen in their bodies, but if the estrogen levels increase they can result in this condition.
Males are more prone to the condition in certain times of their lives. More than 50% of male babies have enlarged breasts from the get-go, thanks to the effects of their mother’s estrogen. The breasts usually decrease in size and are gone by the time the male baby hits three weeks of age.
Puberty is another time males are more likely to experience swollen breast tissue. Once again, the condition usually takes care of itself on its own, lasting anywhere from six months to two years.
Most men remain relatively safe from gynecomastia in the span following puberty until they hit age 50. Men between the ages of 50 and 80 are once again at a higher risk of developing the condition, and the Mayo Clinic notes that about 25% of them do so.
Estrogen levels can vary–causing gynecomastia–due to normal changes in the body. Puberty and aging are two prime times for estrogen levels to increase in proportion to testosterone. Sometimes normal changes are not to blame and the condition stems from certain medication, drugs, substance abuse, or health issues.
What medications and substances can cause gynecomastia?
Gynecomastia can be a side effect of certain medications, and it can also develop due to drug or alcohol abuse. Several medications may be to blame, including anabolic steroids, androgens and anti-androgens, antibiotics, and certain heart and ulcer medications such as cimetidine and digoxin, respectively. Chemotherapy or cancer treatments can lead to the condition, as can certain medications used to treat AIDS, depression, and anxiety.
Alcohol tops the list of substances that can lead to the condition, followed by an array of street drugs. These include heroin, methadone, amphetamines, and marijuana.
What underlying health conditions may be to blame?
If you find an underlying health condition is causing gynecomastia, your insurance company may cover treatment for that specific health condition. A wide array of health issues can cause breast tissue swelling because such issues throw off the normal balance of hormones in the body.
Tumors, cirrhosis or liver failure, and kidney failure may lead to gynecomastia. The condition can also stem from hyperthyroidism, or an overactive thyroid, and hypogonadism, which consists of a number of conditions that affect the body’s normal production of testosterone.
Starvation and malnutrition can count as additional causes, because testosterone levels decrease when the body does not receive adequate nutrition. Certain herbal products, such as lavender oil or tea tree oil shampoos and lotions, can contribute to gynecomastia.
What other treatments are available?
If none of the substances, medications, age ranges, or underlying health issues are to blame, you can still seek other treatments for gynecomastia. Certain medications may help, such as those used to treat breast cancer or other conditions.
However, even if the drugs have been approved by the FDA to treat breast cancer and other conditions, the Mayo Clinic warns that the drugs have not been approved to treat gynocomastia. This may pose a hurdle when it comes to coverage for such medications under your health insurance plan.
Surgery is another option, although it is not likely to be covered by your health plan. If you were undergoing a surgical procedure for health reasons, it would be a different story. But the surgery required to correct swollen breast tissue would instead fall into the cosmetic category, which health insurance plans do not typically cover.
Your two surgical options are either liposuction or a mastectomy. Liposuction involves removing the fat from the breast area but leaves the breast gland intact. A mastectomy involves removing the breast gland tissue. A mastectomy is actually less invasive than liposuction and usually has a speedier recovery time.
One more option you could try that doesn’t involve surgery or other treatments is losing weight and getting in shape. Eating a healthy diet that helps to reduce your body fat and strengthening your back muscles and posture may help.